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目的:观察初诊2型糖尿病(T2DM)患者血清乳酸脱氢酶(LDH)的水平,及经短期胰岛素泵强化(CSII)治疗后血清LDH的变化,并探讨其变化与胰岛素抵抗的相关性。方法:选取正常糖耐量者(NGT)36例,初诊T2DM患者37例,T2DM组于治疗前后均行口服75 g葡萄糖耐量试验(OGTT),检测各点静脉血浆葡萄糖及胰岛素,并检测血脂、血清LDH等相关代谢指标。结果:①T2DM组血清LDH水平(177.92±43.01)U/L明显高于NGT组(160.97±19.43)U/L,差异有统计学意义(t=2.130,P<0.05)。②T2DM组经CSII强化治疗2周后空腹血糖(FPG)及餐后2 h血糖(2hPG)均明显下降,差异均有统计学意义(P<0.01)。同时稳态模型评估的胰岛素抵抗指数(HOMA-IR)显著下降[2.00(1.35～2.61)vs 1.30(0.91～1.80)]。早相胰岛素分泌(△INS30/△G30)及晚相胰岛素分泌(△INS120/△G120)均明显升高[(1.11±0.95)vs(2.25±2.14),(1.22±1.14)vs(3.57±3.06)],差异均有统计学意义(P<0.05),血清LDH水平显著下降,差异有统计学意义(t=2.397,P<0.05)。③Pearson相关分析显示,T2DM组血清LDH水平与HO-MA-IR成正相关(r=0.359,P<0.05)。④多元逐步回归分析显示,HOMA-IR是影响血清LDH的独立相关因素。结论:初诊T2DM患者经短期CSII强化治疗后胰岛素抵抗及β细胞功能明显改善,同时血清LDH水平显著下降,血清LDH水平与胰岛素抵抗呈正相关。
Objective: To observe the level of serum lactate dehydrogenase (LDH) in patients with newly diagnosed type 2 diabetes mellitus (T2DM) and the change of serum LDH after short-term insulin pump (CSII) treatment, and to explore its relationship with insulin resistance. Methods: Totally 36 patients with normal glucose tolerance (NGT) and 37 patients with newly diagnosed T2DM were enrolled in this study. Before and after treatment, 75 g oral glucose tolerance test (OGTT) was given to the patients with T2DM. Glucose and insulin were measured at each point. Serum LDH and other related metabolic indicators. Results: ① The serum LDH level in T2DM group (177.92 ± 43.01) U / L was significantly higher than that in NGT group (160.97 ± 19.43) U / L, the difference was statistically significant (t = 2.130, P <0.05). ② Fasting plasma glucose (FPG) and 2 h postprandial plasma glucose (2 hPG) in T2DM group were significantly decreased after 2 weeks of intensive treatment with CSII, the difference was statistically significant (P <0.01). At the same time, the HOMA-IR decreased significantly [2.00 (1.35-2.61) vs 1.30 (0.91-1.80)]. (1.11 ± 0.95) vs (2.25 ± 2.14), (1.22 ± 1.14) vs (3.57 ± 3.06) in early phase insulin secretion (△ INS30 / △ G30) and late phase insulin secretion (△ INS120 / △ G120) ), The differences were statistically significant (P <0.05), serum LDH levels were significantly decreased, the difference was statistically significant (t = 2.397, P <0.05). Pearson correlation analysis showed that serum LDH level in T2DM group was positively correlated with HO-MA-IR (r = 0.359, P <0.05). ④ Multiple stepwise regression analysis showed that HOMA-IR was independently related to serum LDH. CONCLUSION: Insulin resistance and β-cell function are significantly improved in newly diagnosed T2DM patients after short-term CSII intensive treatment. Serum LDH levels are significantly decreased, and serum LDH levels are positively correlated with insulin resistance.